Is PharmD going to become the most irrelevant doctorate degree?

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college4ever

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I've been spending some time in the pharmacy forum as someone who might do pharmacy and the top 5 posts are all how PA/NPs are becoming more relevant. PA schools now have HIGHER stats than pharmacy. It is now way easier to get into pharmacy school than PA school, which isnt evne a doctorate. This is pretty concerning as older pharmacists ive talked to used to laugh at idea of PA. These stats pulled from pharmacy forum:

Western University of Health Sciences

Physician Assistant
Applicant Scores
Number of Applications Received 1810
Number of Interviews Granted 493
Number of Students Enrolled 98
Applicant Scores
Average Overall GPA 3.55
Average Prerequisite GPA 3.62
Average Science GPA 3.53

For Pharm.D

Applicant Counts
Number of PharmCAS Applications Received 1046
Number of Interviews Granted 480
Number of Enrolled Students 128
Applicant Scores
Average Overall GPA 3.44
Average Science GPA 3.33

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Become? It already is irrelevant. Having it on my resume got me no jobs in 10 months. I have a better chance of getting job at this point using my bio degree than my pharmd probably. OP if you're concerned just turn around and dont look back! Trust me, you wont regret it.
 
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Probably second to a JD. Many law school graduates already have to resort to working jobs that only require a high school education. I predict that the PharmD will go the same way.
 
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Probably second to a JD. Many law school graduates already have to resort to working jobs that only require a high school education. I predict that the PharmD will go the same way.

At least being in a top 10 or ivy league law school can get you places at a big firm. Pharmacy top 10? UCSF? Psh, go right into the floater applicant pool with ITT tech pharmacy school grad. Doesn't matter at all to CVS or hospitals.
 
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I've been spending some time in the pharmacy forum as someone who might do pharmacy and the top 5 posts are all how PA/NPs are becoming more relevant. PA schools now have HIGHER stats than pharmacy. It is now way easier to get into pharmacy school than PA school, which isnt evne a doctorate. This is pretty concerning as older pharmacists ive talked to used to laugh at idea of PA. These stats pulled from pharmacy forum:

Western University of Health Sciences

Physician Assistant
Applicant Scores
Number of Applications Received 1810
Number of Interviews Granted 493
Number of Students Enrolled 98
Applicant Scores
Average Overall GPA 3.55
Average Prerequisite GPA 3.62
Average Science GPA 3.53

For Pharm.D

Applicant Counts
Number of PharmCAS Applications Received 1046
Number of Interviews Granted 480
Number of Enrolled Students 128
Applicant Scores
Average Overall GPA 3.44
Average Science GPA 3.33

Answer: yep
 
Some misconceptions here:

The degree/field itself is not becoming irrelevant, it's becoming oversaturated. There are too many applicants who want to play physician, "be clinical" and do non traditional pharmacy work.

You seldom read about students interested in pharmacy for retail, they are usually interested in hospital or playing physician which is the major problem. If sticking just to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders. There is nothing that is becoming irrelevant.

Yeah, the retail market right now is subpar, but it's still existent. It's when people say "I can't find a job," and you find out that they went to pharmacy school because they thought they were going to "become doctors," work in a hospital (maybe after doing "JUST" 3 years of residency), and refuse to move out of a major city that it becomes a real problem.
 
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it is not as bad as it seem. My cousin has to commute for couple years while waiting for the location closed to home open. But when the spots open, they will transfer you. You just probably have to work couple years far from home to buy time.
 
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Some misconceptions here:

The degree/field itself is not becoming irrelevant, it's becoming oversaturated. There are too many applicants who want to play physician, "be clinical" and do non traditional pharmacy work.

You seldom read about students interested in pharmacy for retail, they are usually interested in hospital or playing physician which is the major problem. If sticking just to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders. There is nothing that is becoming irrelevant.

Yeah, the retail market right now is subpar, but it's still existent. It's when people say "I can't find a job," and you find out that they went to pharmacy school because they thought they were going to "become doctors," work in a hospital (maybe after doing "JUST" 3 years of residency), and refuse to move out of a major city that it becomes a real problem.

I think you hit the nail on the head. I would say 30% went to pharmacy to be a "phake doctor" (not my words, I saw them on an individuals profile on here) 30% just for the money/income and 40% bc they had no other choice (aka long term unemployment with their undergrad degree, "religious studies" ect).
 
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I've been spending some time in the pharmacy forum as someone who might do pharmacy and the top 5 posts are all how PA/NPs are becoming more relevant. PA schools now have HIGHER stats than pharmacy. It is now way easier to get into pharmacy school than PA school, which isnt evne a doctorate. This is pretty concerning as older pharmacists ive talked to used to laugh at idea of PA. These stats pulled from pharmacy forum:

Western University of Health Sciences

Physician Assistant
Applicant Scores
Number of Applications Received 1810
Number of Interviews Granted 493
Number of Students Enrolled 98
Applicant Scores
Average Overall GPA 3.55
Average Prerequisite GPA 3.62
Average Science GPA 3.53

For Pharm.D

Applicant Counts
Number of PharmCAS Applications Received 1046
Number of Interviews Granted 480
Number of Enrolled Students 128
Applicant Scores
Average Overall GPA 3.44
Average Science GPA 3.33

If you want to go into healthcare but don't want to be a MD/DO than do something else like PA/NP. Pharmacy is a fad career and if you go into it when the going was good, then you would be alright. I think college itself is suffering from saturation. Too many people have the generic bachelors degree, you should go into STEM.
 
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this is a troll post, probably by overstimulating D.O. student just get admitted and think D.O. school is just as good as M.D.
 
Some misconceptions here:

The degree/field itself is not becoming irrelevant, it's becoming oversaturated. There are too many applicants who want to play physician, "be clinical" and do non traditional pharmacy work.

You seldom read about students interested in pharmacy for retail, they are usually interested in hospital or playing physician which is the major problem. If sticking just to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders. There is nothing that is becoming irrelevant.

Yeah, the retail market right now is subpar, but it's still existent. It's when people say "I can't find a job," and you find out that they went to pharmacy school because they thought they were going to "become doctors," work in a hospital (maybe after doing "JUST" 3 years of residency), and refuse to move out of a major city that it becomes a real problem.
Pharmacists are not Physicians. If someone want to be a Physician, becoming a PharmD, is a bad idea.
 
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If sticking just to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders. There is nothing that is becoming irrelevant.
If sticking to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders in the same way that a janitor at Google fulfills a unique role that cannot be encroached on by software engineers, IT engineers and product managers at the same company.

It is "unique" in the sense that the role itself has no value-add, and while there are some duties that do bring value to others such as cleaning bathrooms (in retail pharmacy terms: counting by 5's, taking phone calls, ringing customers up), any employee with a real technical skill set would consider themselves to be "too good" to do this work. Also, these duties can easily be outsourced to anyone off the street (pharmacy technicians) because why would you hire a college grad to be a janitor when you can hire a high school dropout to do the same thing at half the price?
 
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If sticking to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders in the same way that a janitor at Google fulfills a unique role that cannot be encroached on by software engineers, IT engineers and product managers at the same company.

It is "unique" in the sense that the role itself has no value-add, and while there are some duties that do bring value to others such as cleaning bathrooms (in retail pharmacy terms: counting by 5's, taking phone calls, ringing customers up), any employee with a real technical skill set would consider themselves to be "too good" to do this work. Also, these duties can easily be outsourced to anyone off the street (pharmacy technicians) because why would you hire a college grad to be a janitor when you can hire a high school dropout to do the same thing at half the price?

I read your posts often. And I often wonder how you got to a place where you feel like you add absolutely no value to the system? Do you really feel like you are useless? Do you really feel like your education qualifies you for nothing unique?

I’m just curious... I feel quite confident that I contribute to an interdisciplinary team on a regular basis. This is verified by the fact that members of my team seek my input on a regular basis.

Are you working retail? What kind of pharmacy do you practice?
 
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I read your posts often. And I often wonder how you got to a place where you feel like you add absolutely no value to the system? Do you really feel like you are useless? Do you really feel like your education qualifies you for nothing unique?

I’m just curious... I feel quite confident that I contribute to an interdisciplinary team on a regular basis. This is verified by the fact that members of my team seek my input on a regular basis.

Are you working retail? What kind of pharmacy do you practice?
I don't think I said that I felt I added no value to the system as I was talking about retail pharmacists (I'm not one). My organization finds unique value in what I bring to the table but my skillsets are developed as a result of working and not from anything I learned during school and I straddle different domains in my line of work.

A PharmD by itself is worth nothing nowadays, and working as a retail pharmacist at a major chain is pretty close to that as well. So to be "valuable" as a pharmacist, you will need to have a PharmD plus domain knowledge in an area of practice which can only be obtained through work experience, residency/fellowship or a dual degree.
You have to constantly be thinking of what skills you are developing and if they are translatable to other areas. Sadly, most pharmacists don't have this foresight and rely too much on the advice on others - these will be the ones who will not make it as the saturation gets worse and worse and natural selection takes its toll.
 
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Having been a retail pharmacist, I can say- with 100% certainty- that my employers perceived pharmacists as having ZERO value. Management from the top down loathed us. We made "a lot of money" but did little more than work as overpriced cashiers. If you're taught that you are worthless, eventually you will believe it....
 
Having been a retail pharmacist, I can say- with 100% certainty- that my employers perceived pharmacists as having ZERO value. Management from the top down loathed us. We made "a lot of money" but did little more than work as overpriced cashiers. If you're taught that you are worthless, eventually you will believe it....

From a business standpoint, we're only viewed as expensive overhead.
 
Having been a retail pharmacist, I can say- with 100% certainty- that my employers perceived pharmacists as having ZERO value. Management from the top down loathed us. We made "a lot of money" but did little more than work as overpriced cashiers. If you're taught that you are worthless, eventually you will believe it....
Exactly. Most retail pharmacists would counterargue that they should be "counseling" or "using their cognitive abilities" but their business function is tied to dispensing so practically speaking they will never be able to do that. Even if they were allowed to spend most of their time counseling, in the retail setting you will mostly be doing counseling that is focused on things such as:

- Helping someone pick between two PPIs/OTC medications
- Discussing how to take a new medication by reading off the prescription label
- Discussing what supplement is best for bone health
-Discussing most effective contraceptive methods

which are things that don't "improve clinical outcomes," so if I were a business owner why would I pay big bucks for someone to spend their time doing these things?

The only model where counseling "full time" would generate revenue is if you had contracts with insurance companies to do MTMs or CMRs, which are much more targeted "counseling" sessions than simply acting as a concierge service, and at that point you wouldn't even a retail pharmacist anymore (and this "type" of pharmacist also being undercut by organizations such as Aspen Rxhealth).

Finally, another argument retail pharmacists try to make is that "PBMs are reimbursing us poorly, if they paid us more then we will actually feel that we are adequately reimbursed for our services" to which I want to make two points:
1. If you are talking about reimbursement for the total cost of a drug (because retail profitability is ultimately about buying low and selling high to make a margin), then I fail to see how a pharmacist salary is justified because any lay person can do this. Think of all the home/individual businesses that rely on this business model, whether it be reselling clothes, electronics, games etc - most of these people aren't fashion designers, tech gurus or professional gamers and yet they can find success in their business without having any "technical" knowledge of the products they are reselling.
2. If you are talking about increasing reimbursements for dispensing fees paid out to the pharmacies for filling each prescription (from $1 per prescription filled to $10 per prescription filled, for example), then again I fail to see how pharmacists' salaries are justified as technicians who practically make minimum wage salaries can fill a heck of a lot more prescriptions than pharmacists for much cheaper. A similar analogy would be a doctor's office asking a patient to pay $500 instead of $50 for a normal office visit because "the doctor can't survive on $50 and has to be compensated for his time" when in reality the clerk will handling your insurance, the nursing assistant will be taking your vitals/take your history and you will only talk to the real doctor for 3-5 minutes, to which as a consumer I will wonder why I am paying $500 to talk to a doctor for 5 min and think it's a ripoff.

So the bottom line is that retail pharmacists are pretty much worthless and that won't ever change so get out if you can because there's no saving that dying horse.
 
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Pharmacists are not Physicians. If someone want to be a Physician, becoming a PharmD, is a bad idea.

You resurrected a 2-year old thread. Of which case:

Yes, if you want to be a physician, don't be a pharmacist. To the same token, if you want to be a plumber, don't be a welder.
 
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You resurrected a 2-year old thread. Of which case:

Yes, if you want to be a physician, don't be a pharmacist. To the same token, if you want to be a plumber, don't be a welder.

What's wrong with resurrecting an old thread? I see that a lot of threads like this get closed because it's apparently not okay to resurrect old threads. If that is the case then this entire forum should be on Snapchat so the posts disappear after a day.
 
It might be old, but with pharmacy ever so slowly spiraling down the proverbial toilet it's even more relevant now. Can you imagine how relevant it will be at this time NEXT YEAR? And- after all- pathos never goes out of style....
 
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What's wrong with resurrecting an old thread? I see that a lot of threads like this get closed because it's apparently not okay to resurrect old threads. If that is the case then this entire forum should be on Snapchat so the posts disappear after a day.

Whats wrong with beating a dead horse in three different shades of blue? And no, you don't see a lot of threads like "these" get closed because more and more similar topics make it to the top of the list. Rather, you see that most threads get moved around to their proper subforums.

It might be old, but with pharmacy ever so slowly spiraling down the proverbial toilet it's even more relevant now. Can you imagine how relevant it will be at this time NEXT YEAR? And- after all- pathos never goes out of style....

1) Pharmacy is not slowly spiraling down it already hit rock bottom for those that don't prepare.
2) The relevance this time next year when another person opens the conversation stating that physicians are not pharmacists...Yes, I cant wait to be taken back
 
Whats wrong with beating a dead horse in three different shades of blue?

You could say that for this entire forum then. I didn't see this thread two years ago so I appreciate that someone bumped it. I found this to be a valuable discussion.
 
Some misconceptions here:

The degree/field itself is not becoming irrelevant, it's becoming oversaturated. There are too many applicants who want to play physician, "be clinical" and do non traditional pharmacy work.

You seldom read about students interested in pharmacy for retail, they are usually interested in hospital or playing physician which is the major problem. If sticking just to retail, pharmacists fulfill a unique role that cannot be encroached by PAs/NPs/midlevelproviders. There is nothing that is becoming irrelevant.

Yeah, the retail market right now is subpar, but it's still existent. It's when people say "I can't find a job," and you find out that they went to pharmacy school because they thought they were going to "become doctors," work in a hospital (maybe after doing "JUST" 3 years of residency), and refuse to move out of a major city that it becomes a real problem.


We have plenty of NP's, PT's, PA's going around in the hospitals saying that they are doctors... I have never seen pharmacists do that.
 
A PharmD by itself is worth nothing nowadays, and working as a retail pharmacist at a major chain is pretty close to that as well. So to be "valuable" as a pharmacist, you will need to have a PharmD plus domain knowledge in an area of practice which can only be obtained through work experience, residency/fellowship or a dual degree.

Interesting. Would you be willing to give a few examples of domain knowledge that would pair up well in retail?

Once I find some time, I'll try to respond to post #17 as well. Completely off topic, but if I had to guess, I'd say you work for a PBM.
 
Interesting. Would you be willing to give a few examples of domain knowledge that would pair up well in retail?
The problem with retail as I mentioned in other posts is that it is the only pharmacy "specialty" where you become LESS valuable in the more you work because it is just a metrics-based job and someone with no experience can be just as effective as someone with years of experience. So by virtue of being a retail pharmacist you are already in a dead end career which is why there is a stigma associated with being a retail pharmacist and why it is so hard to make the jump to another setting from retail.

What I was talking about above only applies to jobs in other industries; classic examples of these include working as a hospital pharmacist and understanding hospital workflow/operations (domain knowledge) prior to working as an informatics pharmacist, or working as a clinical specialist and understanding the latest guidelines, pivotal trials and pros/cons of each drug in a specific therapeutic area (domain knowledge) before becoming an MSL for a drug company who sells a product in that specific therapeutic area. Likewise, if you worked in an independent pharmacy and were in tune to drug purchasing, contract negotiations etc. then you may to able to leverage that knowledge to work for a wholesaler.
 
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Once I find some time, I'll try to respond to post #17 as well. Completely off topic, but if I had to guess, I'd say you work for a PBM.
What makes you say that? Is it because I'm not one of the 95% of pharmacists who don't know who else to blame for the issues this field is facing so I'm just going to spew the "death to PBMs" rhetoric?

I don't but I do influence health policy as part of my work so keeping up with trends in healthcare and getting the facts straight are both things I am personally interested in doing and critical to my line of work.
 
What makes you say that? Is it because I'm not one of the 95% of pharmacists who don't know who else to blame for the issues this field is facing so I'm just going to spew the "death to PBMs" rhetoric?

At least in your previous posts, you advocate for PBMs when yes, a majority of pharmacists, would name PBMs as the reason retail pharmacy is becoming worse. When an independent pharmacy closes up, what are the reasons they give? One of those reasons will be reimbursement rates. There have been reports about PBMs reimbursing pharmacies less than the cost of the drug... sometimes hundreds of dollars less. Can you justify this practice? You also lump all retail pharmacists together as worthless. In reality, I think many of them just want what is best for their patients and want to make an honest buck too.

Perhaps you should change your name to "Retail pharmacy is a scam"

When you keep the facts straight, do you consider the how much profits PBMs have made in recent years and the increasing costs passed onto taxpayers? Or should these middlemen continue to operate in darkness?
 
At least in your previous posts, you advocate for PBMs when yes, a majority of pharmacists, would name PBMs as the reason retail pharmacy is becoming worse. When an independent pharmacy closes up, what are the reasons they give? One of those reasons will be reimbursement rates. There have been reports about PBMs reimbursing pharmacies less than the cost of the drug... sometimes hundreds of dollars less. Can you justify this practice? You also lump all retail pharmacists together as worthless. In reality, I think many of them just want what is best for their patients and want to make an honest buck too.

Perhaps you should change your name to "Retail pharmacy is a scam"

When you keep the facts straight, do you consider the how much profits PBMs have made in recent years and the increasing costs passed onto taxpayers? Or should these middlemen continue to operate in darkness?
I'm not advocating for them so much as I am pointing out misconceptions. If I wanted to advocate for them I wouldn't be doing that on SDN or Reddit and if PBMs got abolished it wouldn't affect my job anyways so not like I have a hidden agenda. The biggest issue in pharmacy is the oversaturation problem which is the root cause of all the other problems in pharmacy and that is main the reason why I contribute to this forum (to promote awareness of the oversaturation).
 
The problem with retail as I mentioned in other posts is that it is the only pharmacy "specialty" where you become LESS valuable in the more you work because it is just a metrics-based job and someone with no experience can be just as effective as someone with years of experience. So by virtue of being a retail pharmacist you are already in a dead end career which is why there is a stigma associated with being a retail pharmacist and why it is so hard to make the jump to another setting from retail.

What I was talking about above only applies to jobs in other industries; classic examples of these include working as a hospital pharmacist and understanding hospital workflow/operations (domain knowledge) prior to working as an informatics pharmacist, or working as a clinical specialist and understanding the latest guidelines, pivotal trials and pros/cons of each drug in a specific therapeutic area (domain knowledge) before becoming an MSL for a drug company who sells a product in that specific therapeutic area. Likewise, if you worked in an independent pharmacy and were in tune to drug purchasing, contract negotiations etc. then you may to able to leverage that knowledge to work for a wholesaler.
With respect to the domain knowledge to become a clinical pharmacist, I disagree. A new grad could perform just as well compared to a resident if majority of their rotations are all clinical. Schools are already pushing the clinical curriculum. The main reason hospital wants residents is for cheap labor.
 
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With respect to the domain knowledge to become a clinical pharmacist, I disagree. A new grad could perform just as well compared to a resident if majority of their rotations are all clinical. Schools are already pushing the clinical curriculum. The main reason hospital wants residents is for cheap labor.
A new grad cannot step in and do what an ED, ID or oncology pharmacist does because they don't have any experience at all. "Clinical" experience obtained from rotations during school is not standardized and so highly variable that the chances you get even one rotation that is relevant to a specialty you're interested in is slim. For example, most schools would require students to do 6-8 rotations during P4 year which would include a hospital operations rotation, community rotation, ambulatory care rotation, acute care rotation and one or two electives. Even if you picked all "clinical" rotations as electives and got what you want, you would still have what amounts to less than half a year of "clinical" experience (and let's face it, what do most preceptors even let students do on rotations, usually grunt work because the more interesting stuff is given to residents so I wouldn't even call what you learn from P4 rotations "experience"- "shadowing experience" might be a better term do describe what you do on non-retail rotations).

So residency is an equalizer in the sense that it gives you an years' worth of rotations all in the same setting so that you'd have some baseline experience to draw from (even if it still limited experience).
 
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A new grad cannot step in and do what an ED, ID or oncology pharmacist does because they don't have any experience at all. "Clinical" experience obtained from rotations during school is not standardized and so highly variable that the chances you get even one rotation that is relevant to a specialty you're interested in is slim. For example, most schools would require students to do 6-8 rotations during P4 year which would include a hospital operations rotation, community rotation, ambulatory care rotation, acute care rotation and one or two electives. Even if you picked all "clinical" rotations as electives and got what you want, you would still have what amounts to less than half a year of "clinical" experience (and let's face it, what do most preceptors even let students do on rotations, usually grunt work because the more interesting stuff is given to residents so I wouldn't even call what you learn from P4 rotations "experience"- "shadowing experience" might be a better term do describe what you do on non-retail rotations).

So residency is an equalizer in the sense that it gives you an years' worth of rotations all in the same setting so that you'd have some baseline experience to draw from (even if it still limited experience).
I disagree again. First, schools are more clinically focused in their curriculum.

Second, there have been many pharmacists who have not done a residency and work in oncology, ID or ER. They are better than a PGY-1 trained Pharmacist. The knowledge gap between a pharmacist with years of experience in the field w/o residency vs. a PGY-2 /PGY-1 trained pharmacist is minimal. Therefore, you can learn on the job as a new grad. Hospital did hire new grads ten years ago, so your case for residency as a equalizer is not a case at all. Heck, I know new grads in my class who did not do a residency and are working at hospitals.

Third, you and I can agree that pharmacy is not standardized at all. Pharmacy residency is not even standardized. Each hospital does things differently. A resident will be in the same situation as a new grad if he works for a different institution. For example, I know a resident trained in Ambulatory Care focusing on DM, HTN and HLD management working in a inpatient setting. He has never been exposed to vancomycin kinetics or anticoagulants. However, he is learning on the job. His knowledge in the inpatient setting not much different from a new grad other than the credential.

Fourth, this is not medicine. The knowledge gap between a medical resident and medical student is huge. Therefore, residency is required even with standardized clerkships.

I can use your same argument in a retail setting. A pharmacist intern has more experience in workflow at a retail setting, can easily solve insurance problems and knows the system compared to a new grad with no retail experience. In fact, even retail requires some domain knowledge.

Overall, pharmacy residency is just cheap labor and provides a standardized means to network in order to get a job. That’s the only advantage a resident has over a new grad is networking and connections as the knowledge gap between a pharmacy resident and student is minimal.
 
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I disagree again. First, schools are more clinically focused in their curriculum.
I don't know what school you went to but EVERY school "focuses on clinical" in their curriculum. And yet most of your coursework is irrelevant because you're taking classes like chemistry, statistics, law and ethics, health policy etc. which are all "nice to know" subjects but not "clinical." In a standard 3 year didactic curriculum, you'd only be getting 3 quarters of therapeutics and 3 quarters of pharmacology which are the courses most relevant to "being a pharmacist" so I can see a better argument for the curriculum being effective if you had a minimum of 3 years of curriculum in both subjects. But to take one semester of oncology and think you're a specialist now? Come on bro, be realistic. Moreover, coursework does not equal experience so no matter how "prepared" you are from classes, the fact of the matter is that employers only look at your work experience to determine whether you have any knowledge. I haven't heard of anyone who successfully obtained a job because they argued that their school taught them this or that so they have "experience" despite never actually working in a hospital.

Second, there have been many pharmacists who have not done a residency and work in oncology, ID or ER. They are better than a PGY-1 trained Pharmacist. The knowledge gap between a pharmacist with years of experience in the field w/o residency vs. a PGY-2 /PGY-1 trained pharmacist is minimal. Therefore, you can learn on the job as a new grad. Hospital did hire new grads ten years ago, so your case for residency as a equalizer is not a case at all. Heck, I know new grads in my class who did not do a residency and are working at hospitals.
That is not what the original argument is so you are arguing something else altogether. I am arguing that a new grad can't do what a clinical specialist does straight after graduation because they don't have experience. You are arguing that a non-residency trained pharmacist with years of work experience is as capable or more capable than a residency-trained pharmacist for a specialist position and therefore a new grad can take on a specialist position without additional training. I agree with the first part of your argument (non-residency trained pharmacist with years of work experience can be better than a residency grad); however your argument doesn't make sense because the non-residency trained grad still has something the new grad doesn't have and that is WORK EXPERIENCE. Is residency cheap labor? Yes I believe so. But it is "cheap labor" aka WORK EXPERIENCE nonetheless that the new grad doesn't have.

Based on your comments I should also clarify that I am also differentiating "hospital staffing" positions from "clinical" positions where the former I do believe a new grad can do while the latter a new grad cannot. New grads who are hired into hospitals are most definitely getting staffing positions and not clinical positions. But since you are a new grad and I've been working in the industry for a number of years now let me share some advice to you from a hiring manager perspective: nobody hires based on "potential" or "letting someone with no experience learn on the job" anymore (unless there's the usual nepotism stuff etc.) because there are plenty of candidates with relevant work experience looking for jobs already so why bother spending the time and resources to train someone from the ground anymore when you can hire someone who knows what they're doing from day 1? And if this is how hiring managers are already thinking/experiencing then even if "specialist" positions are not any more difficult than any other entry-level roles, you would still have no shot as a new grad because you're just going to be beat out by people with ANY experience anyways so it's a moot point arguing how capable new grads are. To quote from the Joker: "All of you, the system that knows so much: you decide what's right or wrong the same way you decide what's funny or not." In other words, society (aka the workforce) decides what is valuable or not and as an individual you got to play by those rules, not the other way around.

Third, you and I can agree that pharmacy is not standardized at all. Pharmacy residency is not even standardized. Each hospital does things differently. A resident will be in the same situation as a new grad if he works for a different institution. For example, I know a resident trained in Ambulatory Care focusing on DM, HTN and HLD management working in a inpatient setting. He has never been exposed to vancomycin kinetics or anticoagulants. However, he is learning on the job. His knowledge in the inpatient setting not much different from a new grad other than the credential.
Yes, not all knowledge is transferrable but skills are and experience is experience. Froma clinical standpoint, disease states are all interrelated so do you not think you see patients in the inpatient setting with HTN, HLD and DM and know how to choose appropriate therapies to manage those disease states that you'd have learned from workin in amb care? If you were tagged as a preceptor for students on their inpatient rotations and had to lead topic discussions or journal clubs then you'd already have had practice with that during your amb care residency since all residencies should have a teaching component to it, while if you were a new grad you wouldn't have either the credibility or experience doing something like that. The bottom line is again that the new grad is worthless because they do not have any experience.

Fourth, this is not medicine. The knowledge gap between a medical resident and medical student is huge. Therefore, residency is required even with standardized clerkships.

Per what I stated above, I agree that medical residency is about acquiring KNOWLEDGE like you said. Phamacy residency is about acquiring WORK EXPERIENCE AND KNOWLEDGE and other transferrable skills like teaching.

Overall, pharmacy residency is just cheap labor and provides a standardized means to network in order to get a job. That’s the only advantage a resident has over a new grad is networking and connections as the knowledge gap between a pharmacy resident and student is minimal.
Agree with the cheap labor part. But if you think someone with 1 year of work experience doesn't have a knowledge advantage compared to someone with no work experience then you are out of your mind.

Fifth, the fact hospitals are thinking about making a PGY-3 in medication safety shows you that they want to cut costs in pharmacy. A pharmacist represents overhead nothing more. I am surprised that retail has not asked for a community residency just to cut costs with training a new grad.
Retail chains already have community pharmacy residencies and they have been expanding the number of them. If your argument is that "new grads are cheaper so they should be considered for clinical roles" then that falls right in line with the whole purpose of why institutions and chains alike are massively expanding the number of residency positions (but not real jobs).
 
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I don't know what school you went to but EVERY school "focuses on clinical" in their curriculum. And yet most of your coursework is irrelevant because you're taking classes like chemistry, statistics, law and ethics, health policy etc. which are all "nice to know" subjects but not "clinical." In a standard 3 year didactic curriculum, you'd only be getting 3 quarters of therapeutics and 3 quarters of pharmacology which are the courses most relevant to "being a pharmacist" so I can see a better argument for the curriculum being effective if you had a minimum of 3 years of curriculum in both subjects. But to take one semester of oncology and think you're a specialist now? Come on bro, be realistic. Moreover, coursework does not equal experience so no matter how "prepared" you are from classes, the fact of the matter is that employers only look at your work experience to determine whether you have any knowledge. I haven't heard of anyone who successfully obtained a job because they argued that their school taught them this or that so they have "experience" despite never actually working in a hospital.


That is not what the original argument is so you are arguing something else altogether. I am arguing that a new grad can't do what a clinical specialist does straight after graduation because they don't have experience. You are arguing that a non-residency trained pharmacist with years of work experience is as capable or more capable than a residency-trained pharmacist for a specialist position and therefore a new grad can take on a specialist position without additional training. I agree with the first part of your argument (non-residency trained pharmacist with years of work experience can be better than a residency grad); however your argument doesn't make sense because the non-residency trained grad still has something the new grad doesn't have and that is WORK EXPERIENCE. Is residency cheap labor? Yes I believe so. But it is "cheap labor" aka WORK EXPERIENCE nonetheless that the new grad doesn't have.

Based on your comments I should also clarify that I am also differentiating "hospital staffing" positions from "clinical" positions where the former I do believe a new grad can do while the latter a new grad cannot. New grads who are hired into hospitals are most definitely getting staffing positions and not clinical positions. But since you are a new grad and I've been working in the industry for a number of years now let me share some advice to you from a hiring manager perspective: nobody hires based on "potential" or "letting someone with no experience learn on the job" anymore (unless there's the usual nepotism stuff etc.) because there are plenty of candidates with relevant work experience looking for jobs already so why bother spending the time and resources to train someone from the ground anymore when you can hire someone who knows what they're doing from day 1? And if this is how hiring managers are already thinking/experiencing then even if "specialist" positions are not any more difficult than any other entry-level roles, you would still have no shot as a new grad because you're just going to be beat out by people with ANY experience anyways so it's a moot point arguing how capable new grads are. To quote from the Joker: "All of you, the system that knows so much: you decide what's right or wrong the same way you decide what's funny or not." In other words, society (aka the workforce) decides what is valuable or not and as an individual you got to play by those rules.


Yes, not all knowledge is transferrable but skills are and experience is experience. Froma clinical standpoint, disease states are all interrelated so do you not think you see patients in the inpatient setting with HTN, HLD and DM and know how to choose appropriate therapies to manage those disease states that you'd have learned from workin in amb care? If you were tagged as a preceptor for students on their inpatient rotations and had to lead topic discussions or journal clubs then you'd already have had practice with that during your amb care residency since all residencies should have a teaching component to it, while if you were a new grad you wouldn't have either the credibility or experience doing something like that. The bottom line is again that the new grad is worthless because they do not have any experience.



Per what I stated above, I agree that medical residency is about acquiring KNOWLEDGE like you said. Phamacy residency is about acquiring WORK EXPERIENCE AND KNOWLEDGE and other transferrable skills like teaching.


Agree with the cheap labor part. But if you think someone with 1 year of work experience doesn't have a knowledge advantage compared to someone with no work experience then you are out of your mind.


Retail chains already have community pharmacy residencies and they have been expanding the number of them. If your argument is that "new grads are cheaper so they should be considered for clinical roles" then that falls right in line with the whole purpose of why institutions and chains alike are massively expanding the number of residency positions (but not real jobs).
I agree with you on the curriculum. And I agree with your argument is that a new grad can’t be compared to Clinical specialist with years of experience. What I am arguing is there is no difference between a PGY-1 resident vs. a new grad, if it is, it is very minimal. PGY-1 grad cannot automatically step in become a Clinical specialist either. They only had five weeks in ER, five weeks in Oncology etc. That’s not work experience. That’s another round of rotations. And with respect to staffing, a new grad can perform just as well as a PGY-1.
Also, your argument about a teaching component is null and void. I also had a teaching component during my P4 rotations, led topic discussions, and led Critical journal club discussions that impacted the hospitals formulary. There is nothing that differentiates between PGY-1 vs a new grad. The only difference would be if PGY-1s are practicing independent from day 1 in each 5 week setting , which I have not seen in the hospital I rotated in. And a pharmacy resident should be practicing independently from day 1, after all they have been licensed to practice, not sit behind the coat tails of their preceptor. It reflects poorly on the profession.

In comparison, a medical resident is practicing from day 1 independently other than reporting to the attending for major problems, and he is also acquiring work experience and knowledge. Whereas, the line is blurred between a pharmacy resident PGY-1 and a new grad.

With respect to the ambulatory care resident, your argument is still null and void if majority of time , the resident is dosing antibiotics, managing pain meds, and dosing warfarin based on INR.

And those pharmacists without a residency and are clinical specialists due to years of experience were new grads themselves with no experience initially. The point being is that residency does not translate to work experience and they won’t be an expert in ER, ID or Oncology or staff from day 1 vs a Clinical specialists. Experience comes from practicing in ER, Oncology or ID for many years. regardless of whether you are a new grad or PGY1 resident.

Plus, in the age of information, a new grad with majority of clinical rotations can keep with the clinical knowledge and know the pros and cons of drugs compared to a PGY-1 resident. PGY-1 residency is just fifth year rotations, not work experience unless they practice without a preceptor from day 1.

Lastly, another argument can be a made is a Clinical pharmacist w/o residency and 10 years of experience in the ER is more experienced than a PGY-2 trained ER pharmacist. The point being is residency is not actual work experience per se. it is interning for two years and having a standardized way to network to acquire a job in a hospital setting.
 
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I agree with you on the curriculum. And I agree with your argument is that a new grad can’t be compared to Clinical specialist with years of experience. What I am arguing is there is no difference between a PGY-1 resident vs. a new grad, if it is, it is very minimal. PGY-1 grad cannot automatically step in become a Clinical specialist either. They only had five weeks in ER, five weeks in Oncology etc. That’s not work experience. That’s another round of rotations. And with respect to staffing, a new grad can perform just as well as a PGY-1.
Also, your argument about a teaching component is null and void. I also had a teaching component during my P4 rotations, led topic discussions, and led Critical journal club discussions that impacted the hospitals formulary. There is nothing that differentiates between PGY-1 vs a new grad. The only difference would be if PGY-1s are practicing independent from day 1 in each 5 week setting , which I have not seen in the hospital I rotated in. And a pharmacy resident should be practicing from day 1, after all they have been licensed to practice.

In comparison, a medical resident is practicing from day 1 independently other than reporting to the attending for major problems, and he is also acquiring work experience and knowledge. Whereas, the line is blurred between a pharmacy resident PGY-1 and a new grad.

With respect to the ambulatory care resident, your argument is still null and void if majority of time , the resident is dosing antibiotics, managing pain meds, and dosing warfarin based on INR.

And those pharmacists without a residency and are clinical specialists due to years of experience were new grads themselves with no experience initially. The point being is that residency does not translate to work experience and they won’t be an expert in ER, ID or Oncology or staff from day 1 vs a Clinical specialists. Experience comes from practicing in ER, Oncology or ID for many years. regardless of whether you are a new grad or PGY1 resident.

Plus, in the age of information, a new grad with majority of clinical rotations can keep with the clinical knowledge and know the pros and cons of drugs compared to a PGY-1 resident. PGY-1 residency is just fifth year rotations, not work experience unless they practice without a preceptor from day 1.
You're not getting the point. Like I said, despite it being cheap labor, residency gives you more work experience on top of what a new grad has. Even if your oncology rotation during residency is only 5 weeks long, that is still 5 weeks more than what a new grad has and hiring is always done relative to the field of applicants. You also don't have the credibility as a student to go to certain meetings or participate in certain activities so the student vs resident experience is not the same.

It's easy to nitpick but go get some work experience first and I'm sure your perspective will change. When I was a student/resident I was confident in my abilities and had several "hard to get" rotations from school that required applications, essays etc. to get into so I thought that would help me be considered for jobs but I was passed up for other candidates who had years of experience. Couple years later I look back and I completely understand why new grads aren't being considered for positions anymore. They just don't have the knowledge, confidence and maturity that you can get only through working.
 
You're not getting the point. Like I said, despite it being cheap labor, residency gives you more work experience on top of what a new grad has. Even if your oncology rotation during residency is only 5 weeks long, that is still 5 weeks more than what a new grad has and hiring is always done relative to the field of applicants. You also don't have the credibility as a student to go to certain meetings or participate in certain activities so the student vs resident experience is not the same.

It's easy to nitpick but go get some work experience first and I'm sure your perspective will change. When I was a student/resident I was confident in my abilities and had several "hard to get" rotations from school that required applications, essays etc. to get into so I thought that would help me be considered for jobs but I was passed up for other candidates who had years of experience. Couple years later I look back and I completely understand why new grads aren't being considered for positions anymore. They just don't have the knowledge, confidence and maturity that you can get only through working.
No, I do get it. Residency is what is required now due to cheap labor, where as in the past it was not. What I am saying is the knowledge gap is non inferior between a new grad vs PGY-1, especially if they both were hired in the same hospital. The way to differentiate a PGY-1 vs a new grad is if a PGY-1 was thrown into practicing in oncology rotation independently from day 1, which does not happen or a PGY-1 having a high score on a mini BCPS exam to qualify to get a residency, which is not implemented in the pharmacy schools. Because there is no standardization with pharmacy residency applications, there is not much difference between a new grad and PGY-1 other than connections and network.
With respect to competency , I know a PGY-1 resident ask me, a P4 student, about a HIV drug when this resident had two rotations in ID on top of her P4 rotations. So it proves that a new grad is non inferior to a PGY-1 if they both worked in the same setting.

The PGY-1’s only advantage is network. And you made my point in that PGY-1 residency provides you an ability to network in ways a new grad cannot. Again, that’s the only advantage.

Your same argument can be made in retail setting and even more so. An intern would be faster at troubleshooting insurance problems, meet metrics on a timely basis vs a new grad with no retail experience.
 
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No, I do get it. Residency is what is required now due to cheap labor, where as in the past it was not. What I am saying is the knowledge gap is non inferior between a new grad vs PGY-1, especially if they both were hired in the same hospital. The way to differentiate a PGY-1 vs a new grad is if a PGY-1 was thrown into practicing in oncology rotation independently from day 1, which does not happen or a PGY-1 having a high score on a mini BCPS exam to qualify to get a residency, which is not implemented in the pharmacy schools. Because there is no standardization with pharmacy residency applications, there is not much difference between a new grad and PGY-1 other than connections and network.
With respect to competency , I know a PGY-1 resident ask me, a P4 student, about a HIV drug when this resident had two rotations in ID on top of her P4 rotations. So it proves that a new grad is non inferior to a PGY-1 if they both worked in the same setting.

The PGY-1’s only advantage is network. And you made my point in that PGY-1 residency provides you an ability to network in ways a new grad cannot. Again, that’s the only advantage.

Your same argument can be made in retail setting and even more so. An intern would be faster at troubleshooting insurance problems, meet metrics on a timely basis vs a new grad with no retail experience.
Your personal experience seems to be a one-off that you are turning into a generalization. By virtue of it being another "application," getting residency itself acts as another barrier to selecting for the best, most driven pharmacy students.

Therefore, the average pharmacy student who obtained a residency is smarter (validated by who they interviewed with and the fact that they matched) than the average pharmacy student who didn't do a residency and even if you discredit how much training residency actually gives you, you still can't argue against the fact that titles aside, you're comparing a more talented student vs an average student. Will there be one-offs on both sides? Sure. But I guarantee you there are more idiots who didn't do a residency than there are idiots who matched for a residency. If you can't agree on even this basic fact then there's no point in discussing this anymore.
 
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When you keep the facts straight, do you consider the how much profits PBMs have made in recent years and the increasing costs passed onto taxpayers? Or should these middlemen continue to operate in darkness?
You should look up the Senate Finance hearing on Prescription Drug Pricing in America (part 3) to get a better context for how our healthcare dollars are being spent. Per Sen. Whitehouse, last year:

-Drug companies spent $221.5m in lobbying
-Out of $480b the U.S. spends on drugs, $323b of that goes to drug companies and $23b goes to PBMs
-Even if PBMs were cut in half that would only save the system 3.5%
-"It's got to be interesting to you all [PBMs] that the pharmaceutical industry has been able to take pressure on their pricing and turn it into, with political jiu-jitsu of an almost magical variety, pressure on their most powerful adversary, the most powerful forces for pushing prices down. So I hope that you at least respect what they've been able to pull off here, that's quite a trick on their part."

That quote pretty much sums up the problem in pharmacy: drug pricing from the pharmaceutical companies.
 
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Your personal experience seems to be a one-off that you are turning into a generalization. By virtue of it being another "application," getting residency itself acts as another barrier to selecting for the best, most driven pharmacy students.

Therefore, the average pharmacy student who obtained a residency is smarter (validated by who they interviewed with and the fact that they matched) than the average pharmacy student who didn't do a residency. Will there be one-offs on both sides? Sure. But I guarantee you there are more idiots who didn't do a residency than there are idiots who matched for a residency. If you can't agree on even this basic fact then there's no point in discussing this anymore.

I agree with you about the average resident being “smarter” based on the majority of my classmates who got residencies were smarter than many people that did not do one in my school.

But this argument is contradictory in that in previous posts you stated that pharmacy is not merit based.
A resident applicant has to have connections too to get a residency, not just being smart.

Secondly, there is no way to measure smartness or competence nationwide unless pharmacy school and the residency programs implemented a standardized exam (BCPS exam), where a high score determines if you get matched rather than focusing on criteria like GPA ( minimum is 3.0 which is low), the number of research projects you did, and the number of rotations you did at the same site(I.e. connections). Standardized exam makes it a fair yet competitive playing field, similar to what medical curriculum does, and it helps people like Hedgehog32 who has the GPA, but does not have the connections nor a research project get a residency.
 
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They interviewed 5 people for my position and some of them did a residency. They can be smarter than me all they want, but I'm the one with a job.
 
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They interviewed 5 people for my position and some of them did a residency. They can be smarter than me all they want, but I'm the one with a job.
But they probably interviewed pharmacists with work experience and not new grads.
 
They interviewed 5 people for my position and some of them did a residency. They can be smarter than me all they want, but I'm the one with a job.
Once you get to the interview, it's all about how you handle the interview itself. It's getting that invitation where credentials or lack thereof play a role.
 
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Once you get to the interview, it's all about how you handle the interview itself. It's getting that invitation where credentials or lack thereof play a role.
Not if the job was already promised to an internal candidate and everyone else interviewing had no chance (i.e. interview is just a formality for HR reasons).

In this case as an employer I would actually consider interviewing non-qualified candidates because potentially burning bridges with them won't hurt you as much as burning bridges with legitimately qualified candidates who are bound to get jobs elsewhere if you don't hire them.
 
Not if the job was already promised to an internal candidate and everyone else interviewing had no chance (i.e. interview is just a formality for HR reasons).
OK, fair point, though I have never personally seen that situation, from either side of the table.

I've heard of them, though... and I hope I never misjudge people badly enough to end up someplace that does that.
 
You should look up the Senate Finance hearing on Prescription Drug Pricing in America (part 3) to get a better context for how our healthcare dollars are being spent. Per Sen. Whitehouse.

The hearing is 2 hours long and I want to listen to it-- just real busy these next 2 weeks. However, I do agree that drug price is another big issue Americans face.
 
The hearing is 2 hours long and I want to listen to it-- just real busy these next 2 weeks. However, I do agree that drug price is another big issue Americans face.
It is probably one of the least biased things I've seen because the PBM reps are testifying under oath. So assuming everything that is discussed in the meeting is factual, it paints a different picture than what the media makes the narrative out to be. By the way, either part 1 or part 2 of the series had drug companies testifying under oath so check that out as well.
 
I agree with you about the average resident being “smarter” based on the majority of my classmates who got residencies were smarter than many people that did not do one in my school.

But this argument is contradictory in that in previous posts you stated that pharmacy is not merit based.
A resident applicant has to have connections too to get a residency, not just being smart.

Secondly, there is no way to measure smartness or competence nationwide unless pharmacy school and the residency programs implemented a standardized exam (BCPS exam), where a high score determines if you get matched rather than focusing on criteria like GPA ( minimum is 3.0 which is low), the number of research projects you did, and the number of rotations you did at the same site(I.e. connections). Standardized exam makes it a fair yet competitive playing field, similar to what medical curriculum does, and it helps people like Hedgehog32 who has the GPA, but does not have the connections nor a research project get a residency.

Medicine is getting rid of the Step 1 scoring system for many of the very reasons you are advocating for:


Residency application should continue to be a holistic review process. Not sure about your perception of what makes a candidate competitive, but GPA, number of research projects, and number of rotations at the site can contribute but are in no way the main reasons someone matches.

Some schools are Pass/Fail curricula. Just "having research" or a publication might get you minor points toward an interview spot. Rotating at the site can help or hurt, but it is not like you can have "connections" to all ten programs you apply to.
 
Medicine is getting rid of the Step 1 scoring system for many of the very reasons you are advocating for:


Residency application should continue to be a holistic review process. Not sure about your perception of what makes a candidate competitive, but GPA, number of research projects, and number of rotations at the site can contribute but are in no way the main reasons someone matches.

Some schools are Pass/Fail curricula. Just "having research" or a publication might get you minor points toward an interview spot. Rotating at the site can help or hurt, but it is not like you can have "connections" to all ten programs you apply to.
Getting a pharmacy residency is way more subjective than medical residency. Another factor I forgot to add is personality and whether the RPD likes the candidate or not.Pharmacy residency should require a standardized exam prior to applications. Adding a standardized exam could minimize the nepotism for the pharmacy residency admission process and could increase match rates. The match rate for pharmacy residency is 60%, which is less than USMD at 80%.

Medical school is getting rid of STEP1 score because the score does not correlate with ones performance in a clinical setting. Medical students still have SHELF exams, STEP2 CK, and STEP2 CS to take to make them competitive. Getting rid of STEP1 is however a direct attack on DO students and IMGs as it will be way harder for them to match into competitive residencies like Surgery or Derm, but DOs could still maybe match into IM specialities, IM, Peds, FM with high STEP2 scores, Pass STEP2 CS, And score high on SHELF exams. There is still objective tests for medicine, where as in pharmacy, there is not.

Bottom line STEP2 CK, STEP2 CS and SHELF scores are going to replace STEP1 for a medical student getting matched.
 
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Getting a pharmacy residency is way more subjective than medical residency. Another factor I forgot to add is personality and whether the RPD likes the candidate or not.Pharmacy residency should require a standardized exam prior to applications. Adding a standardized exam could minimize the nepotism for the pharmacy residency admission process and could increase match rates. The match rate for pharmacy residency is 60%, which is less than USMD at 80%.

Medical school is getting rid of STEP1 score because the score does not correlate with ones performance in a clinical setting. Medical students still have SHELF exams, STEP2 CK, and STEP2 CS to take to make them competitive. Getting rid of STEP1 is however a direct attack on DO students and IMGs as it will be way harder for them to match into competitive residencies like Surgery or Derm, but DOs could still maybe match into IM specialities, IM, Peds, FM with high STEP2 scores, Pass STEP2 CS, And score high on SHELF exams. There is still objective tests for medicine, where as in pharmacy, there is not.

Bottom line STEP2 CK, STEP2 CS and SHELF scores are going to replace STEP1 for a medical student getting matched.

The last thing this profession needs is another standardized exam. Pharmacy residency is cheap labor, why should anyone have to spend money on a stupid exam to get paid a fraction of a staff pharmacist? Residents do the same job as staff pharmacists, most of which have not done a residency or even have a PharmD. Makes no sense.
 
The last thing this profession needs is another standardized exam. Pharmacy residency is cheap labor, why should anyone have to spend money on a stupid exam to get paid a fraction of a staff pharmacist? Residents do the same job as staff pharmacists, most of which have not done a residency or even have a PharmD. Makes no sense.
Times will change in a few years as employers will want residency trained pharmacists working in hospitals as opposed to ones who have not done a residency. The ones who do not have a residency currently working in a pharmacy will be replaced, even RPDs and managers.A standardized exam( clinical exam) levels the playing field for smart students who did not fill a checkbox for research. There are no standards in pharmacy compared to medicine.
 
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Times will change in a few years as employers will want residency trained pharmacists working in hospitals as opposed to ones who have not done a residency. The ones who do not have a residency currently working in a pharmacy will be replaced, even RPDs and managers.A standardized exam( clinical exam) levels the playing field for smart students who did not fill a checkbox for research. Their are no standards in pharmacy compared to medicine.

"There"
 
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